Where Should SGLT-2 Inhibitor Therapy Begin? Thoughts from Drs Mikhail Kosiborod and Neil Skolnik

Following is the second of a 3-part discussion between cardiologist and diabetes researcher Mikhail Kosiborod, MD, and family physician Neil Skolnik, MD, on where treatment of type 2 diabetes with the class of sodium-glucose cotransporter (SGLT2) inhibitors should ideally begin.

There is a faction that feels initiation should be in primary care, where preventive medicine is at the heart of practice.

There is a greater chorus of voices that includes Drs Kosiborod and Skolnik that says first, no class of drugs belongs to one specialty or another and second, that care for the patient with type 2 diabetes, takes a village--the paradigm should be team-based multidisciplinary care.

The conversation begins with an examination of the state of preventive care in the US.

Mikhail Kosiborod, MD, is professor of medicine, University of Missouri Kansas City, vice president, Research, Saint Luke’s Health System, executive director, Cardiometabolic Center Alliance, Director, Cardiometabolic Research and codirector, Haverty Cardiometabolic Center of Excellence, Saint Luke’s Mid America Heart Institute, Kansas City, MO.

Neil Skolnik, MD, is professor of family and community medicine, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA.